Effect of Gushizaizaowan Combined with High-Energy Extracorporeal Shock Wave Therapy on Serum Inflammatory Factor Levels and the Balance of Bone Formation and Resorption in Patients with Steroid-Induced Osteonecrosis of the Femoral Head

doi:10.16458/j.cnki.1007-0893.2025.11.012

Abstract：Objective: To investigate the effect of Gushizaizaowan combined with high-energy extracorporeal shock wave therapy on serum inflammatory factor levels and the balance of bone formation and resorption in patients with steroid-induced osteonecrosis of the femoral head. Methods: A total of 113 patients with steroid-induced osteonecrosis of the femoral head (liver-kidney deficiency type) admitted to Zhengzhou Traditional Chinese Medicine Orthopedic Hospital from October 2022 to January 2024 were selected as the study subjects. They were randomly divided into a conventional group (56 cases) and an observation group (57 cases). The conventional group received high-energy extracorporeal shock wave therapy, while the observation group received additional Gushizaizaowan treatment. The clinical efficacy, TCM syndrome scores before and after treatment, serum inflammatory factor levels, bone metabolic indicators, femoral head collapse status, and incidence of adverse reactions were compared between the two groups. Results: The total effective rate of the observation group was higher than that of the conventional group, with a statistically significant difference (P < 0.05). After treatment, the TCM syndrome score of the observation group was lower than that of the conventional group, with a statistically significant difference (P < 0.05). After treatment, the serum levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the observation group were lower than those in the conventional group, with a statistically significant difference (P < 0.05). After treatment, the serum levels of total type I collagen amino-terminal propeptide (T-PINP), N-terminal mid-region of osteocalcin (N-MID), and β-type collagen-specific sequence (β-CTx) in the observation group were lower than those in the conventional group, while the level of 25-hydroxyvitamin D [25-(OH)D] was higher, with statistically significant differences (P < 0.05). There was no statistically significant difference in the femoral head collapse rate between the two groups (P > 0.05). No obvious adverse reactions occurred in either group. Conclusion: Gushizaizaowan combined with high-energy extracorporeal shock wave therapy can enhance clinical efficacy, effectively reduce serum inflammatory factor levels in patients with steroid-induced osteonecrosis of the femoral head, improve clinical symptoms, promote the recovery of the dynamic balance between bone formation and resorption, and does not increase the risk of adverse reactions or femoral head collapse.